Summary
Fifty-nine PCA cups and 61 hydroxyapatite-coated RM cups were included in a prospective randomised study with a mean follow up of 5.2 years. Clinical evaluation revealed better results with the RM cup. Radiological criteria of loosening could be applied only with considerable restrictions as different parameters were assessed: progressively loosened beads in PCA cups and faded contour in RM cups. Migration was measured by a computer assisted method (EBRA). PCA cups showed significantly more longitudinal migration 2 years after operation and subsequently. High migration values correlated with a limp. Loosening as defined by migration was of clinical relevance, could be measured early and predicted the survival rate.
Résumé
Cinquante-neuf cotyles PCA et 61 cotyles RM, recouverts d'hydroxyapatite, ont été rassemblés dans une étude prospective randomisée. La durée d'observation moyenne est de 5,2 ans. L'évaluation clinique, douleur, mobilité, marche, est en faveur du cotyle RM. Les critères radiologiques d'instabilité sont difficiles à apprécier, d'autant qu'il faut évaluer des paramètres différents: fragments progressivement libérés dans les cotyles PCA et irrégularités des contours dans les cotyles RM. Le déplacement a été étudié selon une nouvelle technique computérisée EBRA. Les cotyles PCA ont présenté une migration appréciable, surtout longitudinale, dès la 2ème année post-opératoire et ultérieurement une migration moyenne de 0,6 mm à 5 ans. Il existe une corrélation entre les déplacements importants et la boiterie. L'instabilité cotyloïdienne définie par le déplacement semble correspondre au résultat clinique, même à un stade précoce.
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Krismer, M., Fischer, M., Mayrhofer, P. et al. A prospective study of the migration of two acetabular components. International Orthopaedics 18, 23–28 (1994). https://doi.org/10.1007/BF00180174
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DOI: https://doi.org/10.1007/BF00180174